Gewebethrombolytikum

Gewebethrombolytikum is a recombinant tissue plasminogen activator used to dissolve fibrin clots in acute ischemic stroke and myocardial infarction. The agent activates plasminogen to plasmin, which then degrades fibrin and restores blood flow to the affected tissue. It is typically administered intravenously within a narrow therapeutic window after diagnosis, often within 3 to 4.5 hours from symptom onset in stroke patients. In addition to stroke, it is indicated for certain cases of acute pulmonary embolism and, in some jurisdictions, for acute coronary syndromes when percutaneous coronary intervention is unavailable or delayed.

The pharmacokinetics of gewebethrombolytikum show rapid distribution and a terminal half‑life of approximately 6 to 7 minutes. It is metabolized mainly by proteolytic cleavage and eliminated in the plasma. Dosage regimens vary by indication: for ischemic stroke patients, the standard dose is 0.9 mg/kg, maximum 90 mg, with 10% given as a bolus and the remainder infused over 60 minutes. In myocardial infarction, a dose of 15–30 μg/kg is used. Premedication or concurrent anticoagulation may affect its effectiveness and safety profile.

Contraindications include active internal bleeding, recent intracranial or intraspinal surgery, serious head trauma, or uncontrolled hypertension. Common adverse events are symptomatic intracranial hemorrhages, systemic bleeding, and allergic reactions. Rare complications include anaphylaxis and seizures.

Clinical studies have established a significant reduction in disability for patients treated early with gewebethrombolytikum compared with placebo. Ongoing research evaluates its use in extended windows, combination therapy with antiplatelets, and formulation improvement with reduced thrombotic risk.